Working with Medical Assistants: Understanding MA Scope of Practice

Article Categories: Nursing News & Nurse On the Job

Nurses working in clinical settings are fortunate to have Medical Assistants (MA) as team members. Medical Assistants are allied health professionals who support physicians and office practices in a variety of ways. Certification requires one to two years of training. An MA is uniquely qualified to perform both clinical and administrative duties, which allows for a practice to run efficiently while containing costs.

Every practice and clinic setting has different requirements. In a small private practice, an MA may participate in everything, from making appointments, handling billing, changing dressings, or providing patient education. MAs can receive special instruction to perform specific patient-related duties. Examples: lab draws and tests, electrocardiograms, electroencephalograms, or administer vaccinations.

Because Medical Assistants can be so versatile, it can be easy to ask them to exceed their scope of practice. As an RN, if you work with or supervise MAs, you should know what you can--and can’t!--ask them to do. Each state has laws regarding who has oversight of the MA; sometimes it is only a physician. Knowing your state’s MA scope of practice can prevent liability for all involved. (Only California has specific lists of approved tasks and services.)

In general, a Medical Assistant MAY do the following clinical tasks:

• Take and document vital signs
• Record patient information about past conditions and reason for the current visit
• Escort patients to exam room and prepare them for a procedure, including offering a gown, draping, shaving, and prepping an area with disinfectants.
• Operate diagnostic equipment (but not discuss or interpret data)
• Provide a single dose of an oral medication, when ordered by a physician. The medication must be taken immediately as the MA observes.
• Give medications as ordered by a physician by the following routes: topical, sublingual, vaginal, rectal, and injection
• Perform aseptic procedures, such as wound care. An MA can also change dressings.
• Remove sutures from superficial wounds, lacerations, or incisions
• Perform standard testing in a medical office, such as urinalysis or blood tests on an approved portable device
• Provide patient instructions and education
• Collect blood samples by venipuncture or capillary method
• Use medical terminology and abbreviations
• Relay information to patients from the physician
• Administer CPR and First Aid

A Medical Assistant MAY NOT do the following:

• Make a patient assessment or decisions regarding medical care
• Offer medical advice about a condition or treatment
• Start, flush, or discontinue an IV (unless state law permits)
• Analyze or interpret test results
• Administer anesthesia medication, except topical numbing creams
• Inject medication into a vein (unless state law permits)
• Operate laser equipment

In addition, a Medical Assistant cannot do the following INDEPENDENTLY:

• Triage
• Give advice over the telephone
• Offer medication samples
• Process medication refills
• Diagnose or treat patients

During a busy day, it can be tempting to ask an MA to do something that will help ease the demands and stress of a situation. But boundaries must be recognized. Just as Registered Nurses must work within the Nursing Scope of Practice for the state where they are licensed, Medical Assistants must do the same.